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India posts world record COVID cases with oxygen running out

By Neha Arora and Sachin Ravikumar

NEW DELHI (Reuters) – India recorded the world’s highest daily tally of 314,835 COVID-19 infections on Thursday as a second wave of the pandemic raised new fears about the ability of crumbling health services to cope.

Health officials across northern and western India, including the capital, New Delhi, said they were in crisis, with most hospitals full and running out of oxygen.

Some doctors advised patients to stay at home, while a crematorium in the eastern city of Muzaffarpur said it was being overwhelmed with bodies, and grieving families had to wait their turn. A crematorium east of Delhi built funeral pyres in its parking lot.

“Right now there are no beds, no oxygen. Everything else is secondary,” said Shahid Jameel, a virologist and director of the Trivedi School of Biosciences at Ashoka University.

“The infrastructure is crumbling.”

Six hospitals in New Delhi had run out of oxygen, according to a tally shared by the city government, and the city’s deputy chief minister said neighboring states were holding back supplies for their own needs.

“It might become difficult for hospitals here to save lives,” Manish Sisodia said in a televised address.

Another 2,104 people died in the space of a day, taking India’s cumulative toll to 184,657, according to the health ministry data. The previous record rise in cases was in the United States, which had 297,430 new cases on one day in January, though its infection rate has since fallen sharply.

“INDIA WEEPS”

Television showed images of people with empty oxygen cylinders crowding refilling facilities, hoping to save relatives in hospital.

In the western city of Ahmedabad, a man strapped to an oxygen cylinder lay in the back of a car outside a hospital as he waited for a bed.

“Helplessness,” tweeted former foreign secretary Nirupama Menon Rao. “India weeps.”

“We never thought a second wave would hit us so hard,” Kiran Mazumdar Shaw, executive chairman of the healthcare firm Biocon, wrote in the Economic Times.

“Complacency led to unanticipated shortages of medicines, medical supplies and hospital beds.”

Delhi Health Minister Satyendar Jain said the city needed about 5,000 more intensive care beds.

Similar surges of infections, notably in South America, are threatening to overwhelm other health services.

China said it was willing to help India, although it was not immediately clear what this might consist of.

Only a tiny fraction of the Indian population has received a vaccination.

Authorities have announced vaccines will be available to anyone over 18 from May 1, but experts say there will not be enough for the 600 million people who will become eligible.

Health experts say India let its guard down during the winter, when daily cases were about 10,000 and seemed to be under control, and lifted restrictions to allow big gatherings.

MORE INFECTIOUS VARIANTS

New, more infectious variants of the virus, in particular a “double mutant” variant that originated in India, have helped accelerate the surge, but many also blame the politicians.

Prime Minister Narendra Modi’s government ordered an extensive lockdown in the early stages of the pandemic but has been wary of the economic costs of more tough restrictions.

In recent weeks, the government has been criticized for holding packed political rallies for local elections and allowing a Hindu festival at which millions gathered.

“The second wave is a consequence of complacency and mixing and mass gatherings. You don’t need a variant to explain the second wave,” said Ramanan Laxminarayan of the Center for Disease Dynamics, Economics and Policy in New Delhi.

This week, Modi urged state governments to use lockdowns as a last resort. He asked people to stay indoors and said the government was working to expand oxygen and vaccine supplies.

He cancelled a visit to West Bengal scheduled for Friday.

A YouTube stream showed a hundred or more supporters attended Interior Minister Amit Shah’s election rally in Harirampur on Thursday.

Most donned saffron-colored face-masks — in sharp contrast to the thousands seen at similar gatherings this month — but were still seated close together.

“We are dying here, and they are holding rallies there,” one woman in the northern city of Lucknow said on television.

Madhukar Pai, professor of epidemiology at McGill University in Canada, said India was a cautionary tale for the world.

“If we declare success too soon, open up everything, give up on public health, and not vaccinate rapidly, the new variants can be devastating,” he tweeted.

(Additional reporting by Sanjeev Miglani, Krishna N. Das, Rupam Jain, Anuron Kumar Mitra, Alasdair Pal, Sumit Khanna, Shilpa Jamkhandikar; Writing by Robert Birsel, William Maclean; Editing by Kim Coghill and Kevin Liffey)

Non-stop cremations cast doubt on India’s counting of COVID dead

By Sumit Khanna, Alasdair Pal and Saurabh Sharma

AHMEDABAD, India (Reuters) – Gas and firewood furnaces at a crematorium in the western Indian state of Gujurat have been running so long without a break during the COVID-19 pandemic that metal parts have begun to melt.

“We are working around the clock at 100% capacity to cremate bodies on time,” Kamlesh Sailor, the president of the trust that runs the crematorium in the diamond-polishing city of Surat, told Reuters.

And with hospitals full and oxygen and medicines in short supply in an already creaky health system, several major cities are reporting far larger numbers of cremations and burials under coronavirus protocols than official COVID-19 death tolls, according to crematorium and cemetery workers, media and a review of government data.

India on Monday registered a record 273,810 new daily infections and 1,619 deaths. Its total number of cases now stands at more than 15 million, second only to the United States.

Reliable data is at the heart of any government response to the pandemic, without which planning for hospital vacancies, oxygen and medicine becomes difficult, experts say.

Government officials say the mismatch in death tallies may be caused by several factors, including over-caution.

A senior state health official said the increase in numbers of cremations had been due to bodies being cremated using COVID protocols “even if there is 0.1% probability of the person being positive”.

“In many cases, patients come to hospital in an extremely critical condition and die before they are tested, and there are instances where patients are brought dead to hospital, and we do not know if they are positive or not,” the official said.

‘VERY IRKSOME’

But Bhramar Mukherjee, a professor of biostatistics and epidemiology at the University of Michigan, said many parts of India were in “data denial”.

“Everything is so muddy,” she said. “It feels like nobody understands the situation very clearly, and that’s very irksome.”

In Surat, Gujarat’s second largest city, Sailor’s Kurukshetra crematorium and a second crematorium known as Umra have cremated more than 100 bodies a day under COVID protocols over the last week, far in excess of the city’s official daily COVID death toll of around 25, according to interviews with workers.

Prashant Kabrawala, trustee of Narayan Trust, which manages a third city crematorium called Ashwinikumar, declined to provide the number of bodies received under COVID protocols, but said cremations there had tripled in recent weeks.

“I have been regularly going to the crematorium since 1987, and been involved in its day-to-day functioning since 2005, but I haven’t seen so many dead bodies coming for cremation in all these years,” even during an outbreak of the bubonic plague in 1994 and floods in 2006.

Government spokesmen in Gujurat did not respond to requests for comment.

India is not the only country to have its coronavirus statistics questioned. But the testimony of workers and a growing body of academic literature suggest deaths in India are being under reported compared to other countries.

Mukherjee’s research of India’s first wave concludes that there were 11 times more infections than were reported, in line with estimates from studies in other countries. There were also between two and five times as many deaths than were reported, far in excess of global averages.

WORKING DAY AND NIGHT

In Lucknow, capital of the populous northern state of Uttar Pradesh, data from the largest COVID-only crematorium, Baikunthdham, shows double the number of bodies arriving on six different days in April than government data on COVID deaths for the entire city.

The figures do not take into account a second COVID-only crematorium in the city, or burials in the Muslim community that makes up a quarter of the city’s population.

Crematorium head Azad, who goes by only one name, said the number of cremations under COVID protocols had risen five-fold in recent weeks.

“We are working day and night,” he said. “The incinerators are running full time but still many people have to wait with the bodies for the last rites.”

A spokesman for the Uttar Pradesh government did not respond to a request for comment.

Elsewhere, India Today reported two crematoriums in Bhopal, the capital of the central state of Madhya Pradesh, 187 bodies were cremated following COVID protocols in four days this month, while the official COVID death toll stood at five.

Last week Sandesh, a Gujarati newspaper, counted 63 bodies leaving a single COVID-only hospital for burial in the state’s largest city, Ahmedabad, on a day where government data showed 20 coronavirus deaths.

The Lancet medical journal noted last year that four Indian states making up 65% of COVID fatalities nationally each registered 100% of their coronavirus deaths.

But fewer than a quarter of deaths in India are medically certified, particularly in rural areas, meaning the true COVID death rate in many of India’s 24 other states may never be known.

“Most of the deaths are not registered so it’s impossible to do a validation calculation,” Mukherjee said.

(Reporting by Sumit Khanna in Ahmedabad, Saurabh Sharma in Lucknow and Alasdair Pal in New Delhi)